Provider Demographics
NPI:1801804943
Name:ALEXANDER, RANYA L (MD)
Entity type:Individual
Prefix:DR
First Name:RANYA
Middle Name:L
Last Name:ALEXANDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:18231 IRVINE BLVD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-3432
Mailing Address - Country:US
Mailing Address - Phone:714-389-5700
Mailing Address - Fax:714-389-6973
Practice Address - Street 1:6136 LAKE MURRAY BLVD
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-2502
Practice Address - Country:US
Practice Address - Phone:714-389-5700
Practice Address - Fax:714-389-6973
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2011-05-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA30469207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A304690Medicaid
CAWA30469DMedicare ID - Type Unspecified
CAA26119Medicare UPIN